الفهرس 
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Abstract
Background: End stage Liver disease is usually accompanied by
a decline in systemic vascular resistance (SVR) and haemodynamic
changes that can be of significance when combined with anaesthesia
adminsterd during liver transplantation
Aim to assess the impact of intra-operative and post-operative
Terlipressin infusion in respect to Haemodynamic and renal parameters.
Patient and Methods: After ethics committee approval for this
prospective hospital based comparative study. Fifty recipients were
allocated into Controls group (n = 25) and Terlipressin group (n = 25), In
Terlipressin group Terlipressin infusion started at beginning of surgery
(1.0 μg/kg / hr), the rate later titrated (1.0 – 4.0 μg/kg / hr) to maintain a
MAP > 65 mmHg and SVRI < 2600 dyne·s/cm5 / m2 till day 4.
Norepinepherine infusion was used as appropriate in all patients.
Haemodynamic and Oesophageal Doppler parameters, Renal function,
Peak Portal Vein Blood flow velocity(PPV), Hepatic Artery Resistive
Index (HARI), urine output, liver enzymes, catecholamine support and
ICU stay were compared intraoperatively and 4 days postoperatively.
Results: Terlipressin was able to maintain better MAP and SVR
(P<0 .01) during reperfusion compared to Controls (66.5 + 16.08 versus
47.7+ 4.7 mmHg and 687.7 + 189.7 versus 425.0 + 26.0 dyn.sec/cm5),
respectively. Noradrenaline was only used in 5 patients out of 25 versus
20 in controls. Urea, creatinine, urine output, liver enzymes and ICU stay
were significantly better with Terlipressin. Portal blood velocity was
reduced with Terlipressin without affecting hepatic artery blood flow.
Summary
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Conclusion: Terlipressin infusion significantly improved low SVR
and blood pressure with less need for catecholamine support and with
lesser renal dysfunctions Peak portal blood flow was reduced without
hepatic artery vasoconstriction and with less impairment of postoperative
liver functions tests .